. Enfermedades de los riñones, uréteres y vejiga, con especial referencia a las enfermedades de las mujeres. Pelvis, y cuanto mayor sea la inserción en el pel-vis, más eficaz será la obstrucción y mayor será la hidronefrosis. La posición y la forma de un riñón hidronefrótico en varios estados de distensión se ilustran bien en la Figura 257, mientras que en la Figura 258 se muestra un mecanismo diferente, pero también muy común, en la formación de una hidronefrosis por movabilidad; aquí la obstrucción surge porque el descenso del riñón dentro de sus propias cubiertas fascial resulta en un doblez del uréter. TheKid

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. Diseases of the kidneys, ureters and bladder, with special reference to the diseases of women. pelvis, and the higher the insertion into the pel-vis the more effectual the obstruction and the larger the hydronephrosis. The position and shape of a hydronephrotic kidney in various states ofdistention are well illustrated in Figure 257, while in Figure 258 is shown adifferent, but also very common, mechanism in the formation of a hydro-nephrosis by movability; here the obstruction arises because the descent of thekidney inside its own fascial coverings results in a kinking of the ureter. Thekidney descends, but its pelvis and the uretero-pelvic junction are so held by ETIOLOGY. 531 fascial coverini;s that they cannot follow. Xoto the valve in -3 (Fig. 258).Change in posture relieves the valve of tension and allows outflow of contentshy altering diiection of graAity. Cases in Mhicli similar causes have bronght about a hydronephrosis of160 c. c. are shown in Figiircs 251) and 2()0. Occasionally both kidneys are affected in tins manner, as in an autopsycase illustrated by Figure 2G1.. Fig. 260.—Large Hydronephrotic Right Kidney Seen from Behind. The cause of thecondition in this case is twofold: first, descensus; second, a constricting fascial band, partof the renal fascia, which holds the ureter up while the kidney descends and thus formsobstruction through kinking. One-half natural size. (Miss M. P. Age 23, March 30, 190L Autopsy 1706.) 532 HYDRONEPHROSIS. Where the fascia loops around the ureter it is often found thickened andin veritable bands. We feel that many of the cases of supposed supernumeraryblood vessels are really fascial bands. In addition to these lat-ter and abnonnal blood ves-sels, actual pathological ad-hesions due to a previousperinephritis or pericolitisare not infrequent causes ofobstruction to the ureter, provided the kidney is alsoabnormally movable. An illustration of the in-tluonce of posture upon ahydronephrotic kidney inboth distended and emp

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• bookcentury1900
• bookdecade1920
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• bookyear1922